Positive Autism Screening Rates in Toddlers Born During the COVID-19 Pandemic

This cohort study evaluates associations between prenatal exposure to maternal SARS-CoV-2 infection with rates of positive Modified Checklist for Autism in Toddlers, Revised screenings.


Birth Timing and M-CHAT-R Positive Screenings in Preterm and Full-Term Subgroups (COMBO-EHR)
a Prevalence of elevated M-CHAT-R score in COMBO-EHR in pre-pandemic birth group is 0.23 eTable 2.a Prevalence of elevated M-CHAT-R score in COMBO-EHR Preterm pre-pandemic birth group is 0.21 b Prevalence of elevated M-CHAT-R score in COMBO-EHR Full-term pre-pandemic birth group is 0.22 c 95% CI was not able to be estimated due to small sample size.eTable 3.

Birth Timing and M-CHAT-R Positive Screenings in Female and Male Subgroups (COMBO-EHR)
a Prevalence of elevated M-CHAT-R score in COMBO-EHR pre-pandemic birth group among female children is 0.15 b 95% CI was not able to be estimated due to small sample size.c Prevalence of elevated M-CHAT-R score in COMBO-EHR pre-pandemic birth group among male children is 0.28

eTable 5. Birth Timing and M-CHAT-R Positive Screenings in Commercial and Medicaid Insured Subgroups (COMBO-EHR) Predictor B SE Odds Ratio 95% CI P-value Medicaid Insurance (n=1245 a )
a Prevalence of elevated M-CHAT-R score in COMBO-EHR pre-pandemic birth group among those insured by Medicaid is 0.31 b 95% CI could not be estimated due to small sample size.c Prevalence of elevated M-CHAT-R score in COMBO-EHR pre-pandemic birth group among those with Commercial Insurance is 0.096 eTable 6. Sensitivity Analyses of M-CHAT-R

Positive Screenings Excluding Cases Born in March 2020 (n=380 a ) (COMBO- RSCH)
a Prevalence of elevated M-CHAT score in COMBO-EHR in pre-pandemic birth group is 0.19 b Estimate of 95% CI lower limit not able to be estimated due to small sample size.eTable 7.

Birth Timing and M-CHAT-R Positive Screenings in Preterm and Full-Term Subgroup (COMBO-RSCH)
Prevalence of elevated M-CHAT-R score in COMBO-RSCH Preterm unexposed group is 0.50 b Due to small sample size, models could not be estimated with race and ethnicity as covariates so they were omitted.c Estimate of 95% CI lower limit not able to be estimated due to small sample size.
a d Prevalence of elevated M-CHAT-R score in COMBO-RSCH Full term unexposed group is 0.10

eTable 8. Birth Timing and M-CHAT-R Positive Screenings in Female and Male Subgroups (COMBO-RSCH)
a Prevalence of elevated M-CHAT-R score in COMBO-RSCH among female children unexposed to SARS-CoV-2 is 0.06 b OR and/or 95% CI could not be estimated due to small sample size in this predictor group.c Prevalence of elevated M-CHAT-R score in COMBO-RSCH among male children unexposed to SARS-CoV-2 is 0.20 eTable 9.

Maternal Ethnicity: Not Hispanic or Latino (n=163 c )
Prevalence of elevated M-CHAT-R score in COMBO-RSCH pre-pandemic birth group among Hispanic/Latino group is 0.21 b Estimate of 95% CI lower limit not able to be estimated due to small sample size.
a c Prevalence of elevated M-CHAT-R score in COMBO-RSCH pre-pandemic birth group among non-Hispanic/Latino group is 0.09 eTable 10.

Birth Timing and M-CHAT-R Positive Screenings in Commercial and Medicaid Insured Subgroups (COMBO- RSCH)
a Prevalence of elevated M-CHAT-R score in COMBO-RSCH pre-pandemic birth group among those insured by Medicaid is 0.23 b Estimate of 95% CI lower limit not able to be estimated due to small sample size.c Prevalence of elevated M-CHAT-R score in COMBO-RSCH pre-pandemic birth group among those with Commercial Insurance is 0.07 eTable 11.

Sensitivity Analyses of M-CHAT-R Positive Screenings Excluding Cases Without Serology Testing (n=427 a ) (COMBO-EHR)
a Prevalence of elevated M-CHAT-R score in SARS-CoV-2 unexposed group is 0.22 b 95% CI could not be estimated due to small sample size.

eTable 12. SARS-CoV-2 Exposure and M-CHAT-R Positive Screenings in Preterm and Full-Term Subgroup (COMBO-EHR)
a Prevalence of elevated M-CHAT-R scores in COMBO-EHR preterm group unexposed to SARS-CoV-2 is 0.29 b Prevalence of elevated M-CHAT-R scores in COMBO-EHR full term group unexposed to SARS-CoV-2 is 0.23 c 95% CI could not be estimated due to small sample size in this predictor group.eTable 13.

SARS-CoV-2 and MCHAT-R Positive Screenings in Female and Male Subgroups (COMBO-EHR)
Prevalence of elevated M-CHAT score in COMBO-EHR RSCH among female children unexposed to SARS-CoV-2 is 0.19 b 95% CI could not be estimated due to small sample size in this predictor group.c Prevalence of elevated M-CHAT score in COMBO-EHR among male children unexposed to SARS-CoV-2 is 0.38 a

eTable 14. SARS-CoV-2 Exposure and M-CHAT-R Positive Screenings in Ethnicity Subgroups (Hispanic/Latino or Not Hispanic/Latino; COMBO-EHR)
Prevalence of elevated M-CHAT scores in COMBO-EHR Hispanic/Latino group unexposed to SARS-CoV-2 is 0.27 b Prevalence of elevated M-CHAT scores in COMBO-EHR Not Hispanic/Latino group unexposed to SARS-CoV-2 is 0.18 c 95% CI could not be estimated due to small sample size in this predictor group.
a a Prevalence of elevated M-CHAT score in COMBO-EHR SARS-CoV-2 unexposed group among those insured by Medicaid is 0.27 b 95% CI lower was not able to be estimated due to small sample size.c Prevalence of elevated M-CHAT score in COMBO-EHR SARS-CoV-2 unexposed group among those with Commercial Insurance is 0.14

eTable 16. SARS-CoV-2 Exposure and M-CHAT-R Positive Screenings in Preterm and Full-Term Subgroup (COMBO-RSCH)
Prevalence of elevated M-CHAT score in COMBO-RSCH Preterm unexposed group is 0.20 b Due to small sample size, models could not be estimated with race and ethnicity as covariates so they were omitted.c OR and/or 95% CI could not be estimated due to group size of this predictor.d Prevalence of elevated M-CHAT score in COMBO-RSCH Full term unexposed group is 0.20 a

eTable 17. SARS-CoV-2 Exposure and M-CHAT-R Positive Screenings in Female and Male Subgroups (COMBO-RSCH)
Prevalence of elevated M-CHAT score in COMBO-RSCH female infant unexposed group is 0.12 b OR and/or 95% CI not able to be estimated due to small group size in this predictor.c Prevalence of elevated M-CHAT score in COMBO-RSCH male infant unexposed group is 0.25 Prevalence of elevated M-CHAT scores in COMBO-EHR Hispanic/Latino group unexposed to SARS-CoV-2 is 0.25 b Prevalence of elevated M-CHAT scores in COMBO-EHR Hispanic/Latino group unexposed to SARS-CoV-2 is 0.15 c Estimate of 95% CI could not be estimated due to small sample size in this predictor group.
a a